Premature Ejaculation (PE) Specialist in New York, NY

Premature ejaculation (PE) is a prevalent male sexual dysfunction characterized by ejaculation occurring earlier than desired, often with minimal stimulation. This condition impacts personal and relational well-being, but various treatment options are available to help manage it effectively.

If you’re experiencing premature ejaculation, effective treatment options are available to help you regain control and confidence. At Washington Heights Urology, board-certified urologist Dr. Robert J. Valenzuela offers personalized care tailored to your needs. Call us today at (212) 781-9696 or use our secure online form to schedule your consultation in New York, NY.

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What Causes Premature Ejaculation?

1. Neurological Factors

• Central Nervous System (CNS): The brain’s serotonin system significantly influences ejaculatory control. Low levels of serotonin can trigger rapid ejaculation.
• Reflex Arc: The ejaculatory reflex is managed by the spinal cord at thoracolumbar (T12-L2) and sacral (S2-S4) levels.
• Dopaminergic System: Dopamine hyperactivity can exacerbate rapid ejaculation.

2. Hormonal Influences

• Testosterone: Indirectly affects ejaculatory function via libido regulation.
• Prolactin and Oxytocin: Abnormal levels can alter ejaculatory latency and smooth muscle contractions.

3. Peripheral Mechanisms

• Penile Sensitivity: Hypersensitivity of the glans may lead to quicker ejaculation.
• Smooth Muscle Function: Overactivity in the vas deferens or prostate can contribute to PE.

4. Psychological Factors

• Anxiety and Stress: Emotional strain can accelerate ejaculation.
• Learned Behaviors: Early sexual experiences may establish patterns of rushing.

5. Genetic and Developmental Factors

• Certain serotonin transporter polymorphisms and developmental factors can predispose individuals to PE.

Types of Premature Ejaculation

1. Lifelong PE

• Present from the first sexual experience.
• Often linked to biological or genetic factors.

2. Acquired PE

• Develops later due to psychological stress, medical conditions, or medications.

Treatment Options for Premature Ejaculation

Pharmacological Interventions:

• Selective Serotonin Reuptake Inhibitors (SSRIs): Medications like fluoxetine or paroxetine delay ejaculation by increasing serotonin levels.
• Dapoxetine: A short-acting SSRI for on-demand use.
• Tramadol: An opioid analgesic for extending ejaculatory latency.
• PDE5 Inhibitors: Drugs like sildenafil, especially for PE co-occurring with erectile dysfunction.

Non-Pharmacological Interventions:

• Behavioral Therapy: Techniques such as the stop-start method to improve control.
• Cognitive and Couple Therapy: Addresses psychological factors and relationship dynamics.

Innovative Treatments:

• Hyaluronic Acid (HA) Injections: Applied to the glans to reduce sensitivity and increase latency time.

Managing Comorbidities:

• Conditions like erectile dysfunction or hyperthyroidism should be treated concurrently.

Hyaluronic Acid Injections for PE

For men with penile hypersensitivity, hyaluronic acid injections into the glans offer a minimally invasive solution to delay ejaculation.

Advantages:

• Immediate effect with minimal downtime.
• Reversible and localized, targeting only sensitivity issues.

Considerations:

• Temporary side effects like swelling may occur.
• Best suited for PE caused by penile hypersensitivity.

Key Statistics and Insights

• Premature ejaculation affects approximately 20–30% of men globally.
• Early treatment significantly improves sexual satisfaction and confidence.

Premature ejaculation is a complex condition influenced by neurological, hormonal, psychological, and genetic factors. With a range of treatment options available, from medications and behavioral therapy to innovative solutions like HA injections, men can regain control and improve their sexual health.

Consult a qualified urologist or sexual health specialist to determine the best approach for your unique condition.

References:

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2. Cihan A, Demir O, Demir T, Aslan G, Comlekci A, Esen A. The relationship between premature ejaculation and hyperthyroidism. J Urol. 2009 Mar;181(3):1273-80. doi: 10.1016/j.juro.2008.10.150. PMID: 19185321.
3. Corona G, Petrone L, Mannucci E, Jannini EA, Mansani R, Magini A, Giommi R, Forti G, Maggi M. Psycho-biological correlates of rapid ejaculation in patients attending an andrologic unit for sexual dysfunctions. Eur Urol. 2004 Nov;46(5):615-22. doi: 10.1016/j.eururo.2004.07.001. PMID: 15474272.
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8. Chen K, Li Q, Xu T, Zhang X. Hyaluronic acid injection to coronal sulcus of the penis for the treatment of premature ejaculation: a retrospective observational study. BMC Urol. 2023 Apr 1;23(1):55. doi: 10.1186/s12894-023-01214-9. PMID: 37005592; PMCID: PMC10067247.
9. Schifano N, Capogrosso P, Antonini G, Baldini S, Scroppo F, Salonia A, Zerbinati N, Dehò F. The Application of Hyaluronic Acid Injections in Functional and Aesthetic Andrology: A Narrative Review. Gels. 2023 Feb 1;9(2):118. doi: 10.3390/gels9020118. PMID: 36826290; PMCID: PMC9957416.
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